best laid plans

• Bloodwork, appointment with Dr. T NP A and treatment Neupogen injection at Siteman South County

Today didn't go as planned. My absolute neutrophil count (ANC) was too low for treatment. Different medical definitions provide different numbers for what is normal, but here is what I have learned when it comes to absolute neutrophil count numbers and me.

> 1.5 is normal for most people
> 1.0 is normal for me and high enough for me to get treatment
< 1.0 is safe but too low for me to get treatment
< 0.5 is not considered safe and activities are restricted to avoid an infection

The only time that mine has been less than 0.5 was when I had chicken pox and they put me in the hospital. Today my ANC was 0.5. That's not great news, but as I was looking around on-line to try and define a normal ANC, I found the below article... and I quote "because neutrophils are short-lived, the body produces about 100 billion of these cells everyday." 100 billion. Everyday. So I think I'm going to cut my bone marrow a little slack and take this extra week off chemo to recover... and to make 700 billion more neutrophils. No big deal.

https://www.cancercare.org/publications/216-neutropenia_and_infections_what_you_need_to_know

30 hours in Chicago

I'm so glad that we were able to travel to Chicago this weekend. We had an amazing Saturday evening out on Lake Michigan celebrating our friends' anniversary. (I was super worried my new wig might fly off in the windy city. It didn't.) And after a walk around Millennium Park this morning, we spent today with my brother having a yummy brunch outside, spending some more time on a boat and eating ice cream in a friend's backyard. Couldn't have been a nicer weekend.

 

Fill 'er up

• Neupogen injection and IV fluids at Siteman West County

This blog is feeling a little clunky. I've been trying to record all of my cancer related appointments here, to demonstrate just how much stuff there is to do to make it through all of this, but for me that has it feeling more like an appointment log rather than a journal. (That sentence is pretty clunky.) Having a space to clear my head by rounding up the words in my head and putting them on paper (so to speak) is really why I started blogging in the first place. So I'm going to try and get back to that, perhaps losing the chronicling of every single appointment, but hopefully gaining something else.

With all of that being said, today was my third (and last) Neupogen injection for the week and I also received some IV fluids to treat dehydration. It's hard to get enough water down when I'm feeling nauseous and I'm actually surprised that this is the first time so far on this new chemo that they've suggested IV fluids.

ZzzzZzzzzz

Good news

• Bloodwork, appointment with Dr. T NP A and treatment (Folfori #3 - includes Irinotecan #5 and 5-FU) at Siteman South County

The news about yesterday's CT scan is good. The report is a big long detailed thing but the summary is pretty easy to process: things are shrinking. This is a good sign and puts me in the 20% of people who see some shrinkage on this chemo. So we keep going. Maybe this chemo will help to shrink the tumors so that maintenance chemo could be an option again. Or maybe this chemo will continue to be our best option at keeping the cancer at bay. Either way, it's easier to sit here today with some good news. And we even got up and sat in the kitchen area to eat some lunch.

Okay

• CT scan of my chest, abdomen and pelvis at the Barnes West County Imaging Center

I always have a hard time mentally when I'm prepared for one thing and there's a last minute change of plans. My insurance wouldn't approve an MRI this close to my last one and it was the check-in nurse at the Imaging Center who told me and instructed me to call my doctor's office. "But I'm already here............."

It'll be okay. So instead I'll have a full CT, more radiation than we wanted to have, but hopefully we'll get a good idea of what is going on.

• Neupogen injection at the Cancer Care Clinic at Big Barnes

People who brunch

• Neupogen injection at the Cancer Care Clinic at Big Barnes

We started the morning by meeting some friends for a charity 1 mile walk at Forest Park. The weather was nice and it was good to be there supporting friends. Afterwards, we popped into Barnes for my injection. And then out of nowhere, I wanted to eat out... like at an actual restaurant. I can't even remember the last time that eating out sounded like a good plan. My appetite is all over the place and my taste buds haven't been working normally (thanks new chemo) for a couple of months now, so pretty much nothing ever sounds or tastes good. But we went and it was good. And then there was napping.

3 years

• Neupogen injection at Siteman West County

I'm back

• Bloodwork at Siteman West County

Dr. T's office asked me to come back in but after testing it turns out that my liver related blood test results look okay today, actually down from last Tuesday.